Individual
GARY ALEC VERCRUYSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, 2ND FLOOR TAUBMAN CENTER RECP F, ANN ARBOR, MI 48109-5332
(734) 936-5738
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301070008
MI
208600000X
Surgery Physician
L7591
TX
2086S0102X
Surgical Critical Care Physician
Primary
4301070008
MI
2086S0102X
Surgical Critical Care Physician
L7591
TX
2086S0127X
Trauma Surgery Physician
L7591
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165618301
—
TX
01
—
8K1490
BCBS
TX
01
—
P00063023
RAILROAD MEDICARE
TX
Enumeration date
07/05/2006
Last updated
01/15/2019
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